Barry Marshall says stress still not the culprit

A while back at LessWrong someone cited the book “Why Zebras Don’t Get Ulcers”. Shockingly enough, it was published well after Barry Marshall proved that bacteria caused ulcers. It was responded that the scientific consensus is that stress is still a significant cause. I gave it no more thought until I came across an interview with Barry Marshall. He says there was never any good evidence that stress was a cause, and plenty that it makes no difference. Furthermore, he thinks there is scanty evidence for a variety of things attributed to stress. “Everything that’s supposedly caused by stress, I tell people there’s a Nobel Prize there if you find out the real cause.”

His thinking seems in line with Paul Ewald (and Greg Cochran). On that note, schizophrenia (whatever that is) may be caused by a pre-natal infection. Hat-tip to Jason Malloy’s feed at gnxp.

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10 Responses to “Barry Marshall says stress still not the culprit”

I appreciated Jason Malloy’s link too. It seems each month there’s another bit of evidence linking the pathogen theory to schiz (or what we describe as schiz behaviors) as well as to so many other afflictions. I’ve been following the schiz articles (including those by Torrey and Yolkin) ever since I read about Cochran/Ewald in the Atlantic article of about a decade ago. Like Ewald said in that piece, it would take a while before researchers came around to accepting the notion that pathogens are the explanation for most everything we’ve not been able to understand.

BTW, speaking of Marshalls, an interesting blog is Amy Proal’s Bacteriality, which deals with treating many chronic diseases using Trevor (not Barry) Marshall’s protocol, one that flies in the face of traditional treatments of suppressing the immune system. I recalled the skepticism of both Ewald and Cochran regarding the modern medical explanation of autoimmune diseases–“Oh, some people’s immune systems just ‘over-react’ and begin attacking self.”) Uhhh, how could natural selection have resulted in common and very harmful “over-reactions” by the very system most responsible for protecting us? I recall Cochran/Ewald raising the specter of stealth pathogens.

Anyway, I’m no scientist, but Proal’s posts about a different way to treat chronic disease, a way which does not suppress the immune system but rather uses antibiotics to attack inflammation, are quite interesting.

When you’re well and truly sick, say with heart failure, kidney failure, sepsis, etc, you can get what are called ‘stress ulcers’ in your stomach. But the word stress, used in that way, is referring to something qualitatively different than worry about taxes or an upcoming final exam. Really. Extensive third-degree burns generate that kind of stress, but a long commute does not.

If psychological stress has any role, it is small compared with helicobacter. I would guess that it has no causal role.

The best part of the story is that millions of MDs successfully cured ulcers for decades – just by prescribing antibiotics for other conditions. Of course, you could take that in a negative way, since for those decades, millions of MDs were unable to notice cures that must have happened once a month right in front of them. Maybe a few tens of doctors out of those millions noticed this, and almost all of them were effectively quashed by the system.

[…] Yet as the Atlantic article points out, having recourse to randomization isn’t sufficient to generate knowledge. The real problem there is experimenter bias. When there are large incentives to produce results in a particular way, those results tend to be published. Trial-and-error got us thousands of medical papers, but it appears that the vast majority of them are just wrong (one researcher above suggests 90%). In some cases, our knowledge even regresses over time. Ulcers are caused by a bacteria, for instance, not stress — a fact that we used to know, but then somehow forgot. […]